Reporting directly to the Director of Revenue Cycle supporting the Department of Otolaryngology-Head & Neck Surgery, the Coding and Charge Revision Coordinator is responsible for the review and revision of all coding-related pre-billing discrepancies and rejections in compliance with all Departmental, Institutional, government, and managed care policies and guidance. The Coordinator reviews medical record documentation and recommends proper action to optimize clinical revenue and ensure prompt reimbursement. The coordinator performs special projects as determined by the Director.
Review and resolve all assigned tasks and encounters associated with potential coding discrepancies in prebilling system edits and/or claims with outstanding balances. Audit and assess all documentation in the EMR to ensure that services documented in the EMR meet the standard of appropriate diagnoses and procedure codes (ICD10, and CPT). Coordinate with Clinical Operations staff and Faculty as appropriate to prepare coding appeals, Letters of Medical Necessity, and additional documentation requests. Proactively escalate advanced coding concerns to the Director for appropriate follow-up as necessary. Identify accounts that fit appropriate write off resolution criteria and escalate as appropriate. Complete coding recommendations for missing charges in excess of 5 days. Serves as a subject matter expert in regards to coding issues, denial trends, and charge lag concerns.
Provide management with data as requested to support the overall Revenue missions for the Department of Otolaryngology-Head and Neck Surgery. Monitor dashboards in the EMR including missing charge reports and serve as the Charge Champion. Provides coding issues log to leadership to ensure timely resolution of pending coding concerns.
Analyzes submitted charge correction requests, determine an appropriate resolution, and execute the edits as appropriate to achieve account resolution. Partner with Revenue leadership to develop Departmental policies and best practices for charge corrections.
The Coordinator will provide pod-based coverage with the other Coding and Charge Revision Coordinators in the Revenue team to ensure smooth operations throughout the coding, education, and reporting activities relating to revenue optimization and compliance. The coordinator will also assist with the training support of new hires for both clinical operations, revenue cycle, and faculty. The Coordinator will complete special projects under the direction of the Revenue Cycle Manager and Senior Director of Revenue Integrity as assigned.
Bachelor's degree or equivalent in training, education and/or experience plus at least three (3) years of related experience.
Must demonstrate a client focus with excellent organizational, interpersonal, written and oral skills, able to manage several competing priorities in a high-pressure environment effectively and communicate with all levels of staff, management, and outside vendors. Must demonstrate a willingness to contribute to team success, develop collaborative relationships with an orientation towards quality, and be able to work independently as necessary.
Advanced knowledge of ICD-10 and comprehensive experience with Managed Care companies including contracts, insurance benefits, exclusions, claim forms, HMOs, PPOs, Medicare and Medicaid programs required.
Must be able to maintain confidentiality and exercise tact and diplomacy at all times
Must successfully complete systems training requirements.
Equal Opportunity Employer / Disability / Veteran
Columbia University is committed to the hiring of qualified local residents.
Internal Number: 505721
About Columbia University
Columbia University is one of the world's most important centers of research and at the same time a distinctive and distinguished learning environment for undergraduates and graduate students in many scholarly and professional fields. The University recognizes the importance of its location in New York City and seeks to link its research and teaching to the vast resources of a great metropolis. It seeks to attract a diverse and international faculty and student body, to support research and teaching on global issues, and to create academic relationships with many countries and regions. It expects all areas of the university to advance knowledge and learning at the highest level and to convey the products of its efforts to the world.